The Business of Skin Care

To end an informative first day of sessions at the ASDS Annual Meeting, Patricia Farris, MD, shared key pearls on her presentation, “Business of Skin Care.” Farris and her fellow faculty member, Allison Sutton, MD, FRCPC, discussed how to successfully sell the best products in dermatology offices, and the cutting-edge sales models for web stores, retail stores, and in-office dispensing.¹

Video Transcript:

I'm Dr. Patty Farris. I'm a dermatologist and I'm from Metairie, Louisiana. My discussion today in the “Business of Skin Care” was around product selection. I'd like to start with a few pearls for the dispensing doctors, particularly those who may be new at dispensing. I know there's a lot of competition out there. There's a lot of websites, Amazon, Dermstore, all kinds of websites selling against us. And there's also some services that are actually trying to bring dermatologists to the internet and to the consumers directly. But those are really not your competition. Because when a patient comes into your office, they've selected you for your expertise. And you should have expertise in topical skincare. And you really do need to own that. I also think that there's such a great deal of trust and professionalism that occurs between the doctor-patient relationship, that it's important for us as dispensing doctors to remember that we're not treating consumers, we are treating our patients.

I like to very often quote my friend Ruth Tedaldi, who once said on the podium, actually at this meeting, in this very symposium, that any consultation in a dermatologist's office without the discussion of topical skincare is an incomplete consultation. Just like you wouldn't go to the dentist and they wouldn't talk to you about flossing and brushing, we need to do the same to give our patients good advice on everyday skincare.

As far as product selection goes, there are lots of dispensing companies. What I find is that each company seems to have their own niche. Some are great at antioxidants; others are better at unique anti-aging technologies. Some make great sunscreens. So, I think it's important when you're starting to stock your dispensing cabinet that you pick products from the best companies and those products that you really believe in and that you really like yourself. It'll be much easier for you to recommend those products if you're familiar with them and if you have a high level of competence in the science behind them.

To make it simple for a novice dispenser, I say you really need 3 simple skincare regimens that are created by 3 unique products. Each of these regimens contains 2 things that are in common: sunscreen and an antioxidant. These are important in all of the regiments because we need to protect the skin of course, from ultraviolet light and the damage of pollution and the damage that's caused by free radicals. The first regimen is the core regimen, the basic anti-aging regimen, and I call this the protect and repair regimen. This can be used not only in cosmetic patients, but it's also applicable to our patients with skin cancer and other types of concerns. In this particular regimen, there's an antioxidant and a sunscreen. For those patients who have skin cancer, I'd like to recommend sunscreens that contain DNA repair enzymes. These are unique sunscreens that can help patients who have lots of actinic keratosis and skin cancers. Then, I like to use in the night a retinol. I'm a believer in retinols. I know everybody likes to prescribe retinoic acid, but retinol is a much gentler molecule and a much easier molecule to use, and to access for our patients. You can sell reasonably priced retinols and as you all know, retinol gets converted to retinoic acid, and ultimately does the same thing in the intracellular level that retinoic acid does, again with much better tolerability.

The second regimen you need of course is one to treat hyperpigmentation. Again, sunscreen and antioxidants are essential in this regimen. The sunscreen should be one that contains iron oxide. So, these mineral-tinted sunscreens are great because we know that visible light up regulates pigmentation. When you're going to select your antioxidants, try to find those that are tyrosine kinase inhibitors: vitamin C, resveratrol, and phloretin. These are all known to be tyrosine kinase inhibitors.

Finally, you need a treatment product that contains one of the cosmeceutical ingredients to lighten the skin or many of them. And there are things like tranexamic acid, alpha arbutin, and kojic acid. Retinol, of course, is a great skin lightener. Sustamine is a newcomer in the marketplace. So, these are great options that you can sell in your office in the over-the-counter skin-lightening regimen.

Then the last regimen I kind of call the advanced anti-aging regimen. We all know there are those patients who cannot tolerate retinol, cannot tolerate any prescription retinoids. So, for these patients, you may want to add an alternative anti-aging technology, something like a growth factor or a peptide-containing product. There are many options that you can choose from in the sort of alternative anti-aging category. And again, each manufacturer has their own hero ingredient that you can choose from. This makes it super easy for you to have just 3 regimens. And to have 3 products in each core regimen, you may want to also carry some specialty products, things like neck and decolletage creams, and eye creams, of course, are very popular. And I always say if you want to add a fourth regimen, a very simple 3-piece anti-acne regimen is a great idea. Because it's really hard to get prescriptions covered especially for topicals. In the acne arena, adult patients need gentler products than many of our prescription products are too irritating for them. So that might be another fourth regimen that you can add.

My final bit of advice is to consider things that really let the patient understand that you are individualizing their skincare regimen. You're doing that already by selecting products based on their skin type and their skin condition. But you can also take it up a little bit further. If you use something that actually allows you to make an individual skincare product. We've utilized the custom dose in our practice for several years now. Patients love it, it allows you to select ingredients and to create an individualized, formulated serum that the patient goes home with. It's labeled with their name. And again, it's created based on their skincare concerns. So, there are lots of options for the dispensing doctor. Don't be intimidated by the competition. You're the expert. You need to own it. Enjoy.

Transcript edited for clarity.

Reference:

1. Farris P. Business of Skin Care. Presented at: 2022 American Society for Dermatologic Surgery Annual Meeting, October 7-10, Denver Colorado.